Clinical outcomes and progression rate of tricuspid regurgitation in patients with rheumatic mitral valve disease

OBJECTIVE

A substantial proportion of patients with rheumatic heart disease (RHD) have tricuspid regurgitation (TR). This study aimed to identify the impact of functional TR on clinical outcomes and predictors of progression in a large population of patients with RHD.

METHODS

A total of 645 patients with RHD were enrolled, mean age of 47±12 years, 85% female. Functional TR was graded as absent, mild, moderate or severe. TR progression was defined either as worsening of TR degree from baseline to the last follow-up echocardiogram or severe TR at baseline that required surgery or died. Incidence of TR progression was estimated accounting for competing risks.

RESULTS

Functional TR was absent in 3.4%, mild in 83.7%, moderate in 8.5% and severe in 4.3%. Moderate and severe functional TR was associated with adverse outcome (HR 1.91 (95% CI 1.15 to 3.2) for moderate, and 2.30 (95% CI 1.28 to 4.13) for severe TR, after adjustment for other prognostic variables. Event-free survival rate at 3-year follow-up was 91%, 72% and 62% in patients with no or mild, moderate and severe TR, respectively. During mean follow-up of 4.1 years, TR progression occurred in 83 patients (13%) with an overall incidence of 3.7 events (95% CI 2.9 to 4.5) per 100 patient-years. In the Cox model, age (HR 1.71, 95% CI 1.34 to 2.17), New York Heart Association functional class III/IV (HR 2.57, 95% CI 1.54 to 4.30), right atrial area (HR 1.52, 95% CI 1.10 to 2.10) and right ventricular (RV) dysfunction (HR 2.02, 95% CI 1.07 to 3.84) were predictors of TR progression. By considering competing risk, the effect of RV dysfunction on TR progression risk was attenuated.

CONCLUSIONS

In patients with RHD, functional TR was frequent and associated with adverse outcomes. TR may progress over time, mainly related to right-sided cardiac chambers remodelling.

Methods of application of salicylic acid as attenuator of salt stress in cherry tomato

Salt stress caused by excess salts present in irrigation water, is one of the biggest barriers in agricultural production, especially in semi-arid regions. Thus, the use of substances, such as salicylic acid, that minimize the deleterious effects of salinity on plants can be an alternative to ensure satisfactory production. In this context, the objective of this study was to evaluate the effects of different methods of application of salicylic acid on the growth, production and water use efficiency of cherry tomato plants under salt stress. The study was conducted in a greenhouse, using an Entisol soil with a sandy loam texture. The treatments were distributed in a completely randomized design, in a 2×4 factorial arrangement, corresponding to two levels of electrical conductivity of irrigation water - ECw (0.6 and 2.6 dS m-1) and four methods of application of salicylic acid (Control - without application of SA; via spraying; via irrigation and via spraying and irrigation), with five replicates and one plant per plot. The salicylic acid concentration used in the different methods was 1.0 mM. Application of salicylic acid via foliar spraying increased the growth, production and water use efficiency of cherry tomato plants. The salt stress induced by the electrical conductivity of 2.6 dS m-1 was attenuated by the foliar application of salicylic acid. The use of water of 2.6 dS m-1 associated with the application of salicylic acid via irrigation water further intensified the adverse effects of salinity on cherry tomato plants.

Polyurethane foam impregnated with lignin as a filler for the removal of crude oil from contaminated water

The present study describes the influence of the concentration of lignin when used as a filler in polyurethane foam for crude oil sorption. The foams (lignin 0-20wt%) were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis, contact angle and density. The FTIR analysis confirmed urethane linkage formation, showing that the chemical structure of the polymer was preserved, despite the addition of different lignin concentrations. Thermogravimetric analysis showed that the presence of lignin has altered the onset temperature (T_onset) of the foams, decreasing as the concentration of lignin is increased. The contact angle analysis showed a decrease in the hydrophobicity of the foams with increasing lignin concentration. All modified foams showed an improvement in the oil sorption capacity in a PUF/oil/water system, and the PUF-10 showed an improvement of about 35.5% compared to the PUF-blank. The Langmuir isotherm showed a better fit to the data and predicted a maximum oil adsorption of 28.9gg^-1 by the PUF-10. The ΔG° value of -4.4kJmol^-1 indicated that crude oil adsorption process by PUF-10 was spontaneous. The results of reuse of the PUF-10 showed that oil removal efficiency remained greater than 95% after five consecutive cycles.